Five Arguments Against Medical Aid in Dying Just Don’t Hold Up
by Dr. Dwight Moore
- The opposition says MAID Devalues Human Life: Over time, PAS (physician assisted suicide) statutes create a society where it is believed that some lives are just not worth living.
- The increase in use of Medical Aid in Dying is a testimony to people deciding to die with dignity not that life is not worth living. The number of jurisdictions which sanction MAID in the U.S. is steadily growing because of the value people find in managing end of life decisions.
- People who choose this law have done everything in their power to live. They want the dignity of dying a good death rather than one filled with pain and anxiety.
- The opposition says that MAID is Physician Assisted Suicide (PAS): Studies show “existential distress” and “psychological suffering” rather than “unbearable pain” are the primary reasons a patient requests lethal medication. If dying patients struggle with suicidal thoughts, they need counseling.
- Medical Aid in Dying is not suicide. Those who commit suicide face a violent death, are usually alone, leave a mess to clean up, experience overwhelming terror, anxiety, and sadness, are not rational nor making clear decisions, and leave loved ones without the opportunity to say goodbye or have closure.
- Patients who choose MAID are calm, sure of their decision, in a comfortable place, of sound mind, without fear and anxiety, and are assured that the loved ones around them have had a chance to say goodbye.
- If there is concern about depression in the terminal patient, the law requires the opinion of a psychiatrist or psychologist.
- Not all terminal suffering can be relieved. Why should anyone — the state, the medical profession, religious bodies — presume to tell someone else how much suffering they must endure as their life is ending?
- The opposition says that PAS Turns Medical Care Upside Down: PAS corrupts the medical profession, undermines trust, “…harms the physicians and other health care professionals who participate,” and may create “pervasive incentives” to stop medical interventions.
- MAID is a patient centered law. In the states with the law, there has been no compromise to the integrity of the profession, no reduction of trust in doctors, no change in how medicine is practiced, and no pressure on doctors who choose to support their patients with this decision.
- There is no evidence over the 20+ years since Oregon’s first law that “pervasive incentives” have occurred. Families, ethics boards in hospitals, and palliative care specialists do not allow that to happen.
- On June 11, 2019, a new policy position recommended by the Council on Ethical and Judicial Affairs (CEJA 2-A-19 Report) was adopted. For the first time, the AMA affirmed that physicians can provide medical aid in dying “according to the dictates of their conscience without violating their professional obligations.”
- The opposition says that PAS Laws Are Ripe for Abuse:PAS statutes supposedly have safeguards to protect the vulnerable, but the impacts of depression, coercion from family members, and of not having a physician present at death are unknown.
- There has not been one instance of abuse in the 20+ years of these laws. Volunteers and doctors who help assist are diligent about the eligibility of patients for the law.
- The written request process is a safeguard to determine mental competence and understanding of the law. Additionally, there are more than 10 other check points to safeguard the process before the patients receives the medication.
- The opposition says that PAS Endangers the Weak and Vulnerable: With the increasing cost of health care for the disabled, elderly, and extremely ill patients, people may be “coerced or encouraged to end their lives.”
- The evidence doesn’t support this: it is estimated that 41 million people are caregivers to family members, 34 billion hours are spent caring for them, and $470 billion of unpaid contribution is made yearly. The whole culture of end of life is to feed, nurture, support, transport, love, and comfort those who are dying.
- The impact of MAID in the Netherlands has not affected the general public’s perception of the quality of health care or the status of their doctors. As a country they remain one of the highest rated medical communities.
- In the United States, since 1997, eight states and the District of Colombia have enacted medical aid in dying laws; twelve state medical societies have adopted neutral positions on medical aid in dying. Safeguards are in place.
States with medical aid in dying laws: California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont, Washington, Montana (by court decision)
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